Dental erosion is a significant oral health problem that affects millions of individuals around the world. Erosive tooth wear can cause significant tooth damage compromising the esthetics and function of teeth, requiring extensive dental treatment. Typically, dental erosion is caused by direct contact of intrinsic or extrinsic acid exposure to natural tooth enamel. Erosive tooth wear is a form of chemical tooth loss that causes enamel dissolution without involvement of bacterial origin. (Imfeld, 1996). Oral health problems associated with dental erosion of teeth have become more prevalent in recent years due to the popularity of diets high in acidic contents, increase in use of medication causing low salivary flow and systemic conditions such as gastro esophageal reflux disease (GERD) and Bulimia. Erosion no longer affects only the elderly population but can manifest in all age groups of our society. Acids either from intrinsic or extrinsic origin can soften tooth enamel. Softening of the enamel surface is an early manifestation of acid erosion. Subsequently, the tooth structures are dissolved layer by layer or by a mechanical insult, resulting in bulk-loss of tooth material.
Erosive tooth wear from hydrochloric acid when stomach juice is involuntarily regurgitated has been associated with chronic health issues such as in GERD, hiatal hernia, or occur through chronic vomiting like in bulimia nervosa (Schroeder et al., 1995; Valena and Young, 2002; Barron et al., 2003). Prevalence of dental erosion in GERD patients is approximately 24% (Pace et al., 2008). According to the National Eating Disorders Association, approximately 11 million Americans suffer from eating disorders. (Eating Disorders and their Precursors, www.NationalEatingDisorders.org 2005). Moderate to advanced erosion and tooth wear present on the lingual and incisal edges of a patient's upper anterior teeth are manifestations of a systemic condition such as Bulimia and GERD. The majority of these patients require extensive restorative work to return the teeth to optimal function and esthetics.
Various products containing fluoride and/or calcium phosphate are readily available for caries prevention. Many of these products also address the re-mineralization of teeth by providing fluoride as a rinse or gel, but none of the products available address neutralizing the acidity of saliva, which is the natural medium of teeth. Preventive treatments that can reduce tooth damage from hydrochloric acid erosion will certainly benefit patients suffering from acid erosion of the teeth (e.g., patients suffering from GERD, eating disorders, drinking excessive amounts of acidic drinks, etc.)
Accordingly, there is a need for compositions and methods to prevent and treat tooth erosion in patients exhibiting tooth damage. Compositions and methods are needed to re-harden and re-mineralize the teeth. Patients suffering from conditions such as GERD or Bulimia are in need of compositions and methods for treating tooth erosion.